Improving Patient Flow and Reducing Emergency Department Crowding Evaluation Design

2.50
Hdl Handle:
http://hdl.handle.net/10755/162573
Type:
Presentation
Title:
Improving Patient Flow and Reducing Emergency Department Crowding Evaluation Design
Abstract:
Improving Patient Flow and Reducing Emergency Department Crowding Evaluation Design
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:McHugh, Megan, MPP, PhD
P.I. Institution Name:Health Research & Education Trust (HRET) of the American Hospital Association (AHA)
Title:Director, Research
Contact Address:One North Franklin, Suite 3000, Chicago, IL, 60606, USA
Co-Authors:Kevin Van Dyke, MPP; Julie Yonek, MPH
Leadership Conference - Research Abstract: Improving-Patient-Flow and Reducing-Emergency-Department-Crowding Evaluation Design

Purpose: The purpose of this study is to evaluate the effectiveness of patient flow improvement strategies of six participating hospitals in a nationwide ED learning collaborative aimed at improving patient flow and reducing ED crowding. The goal of the project is to conduct a robust evaluation of the strategies.

Design: The evaluation design includes both a quantitative and qualitative component. For the quantitative component, pre- and post-intervention patient-level data is used to assess the effect of the improvement strategies on patient flow. The qualitative component includes an evaluation of the implementation, costs, and sustainability of the strategies.

Setting: Six diverse hospitals participate in the learning collaborative. They include teaching and non-teaching, for-profit and not-for-profit, and urban and rural hospitals.

Participants/Subjects: All staff participate in the patient flow improvement initiatives implemented by their respective hospitals. Each hospital has a core project team, including a project director, a senior level administrator, and a physician champion. The core team and others directly involved in the implementation of the strategy are interviewed for the qualitative component of the study.

Methods: Patient-level data is used to measure improvement, including ED arrival to departure time for admitted and discharged patients, admit decision time to ED departure for admitted patients, and door-to-provider time. In addition, patient-level demographic data and other data to control for differences in pre- and post-implementation patients are collected. All data is collected pre- and post-strategy implementation, or December 2008-February 2009 and December 2009-February 2010, for all participating hospitals.

In-person site visits will occur during the summer/fall of 2009 to all six hospitals for the purpose of the implementation analysis. Interview questions are asked about rationale for strategy implementation, costs associated with implementation, barriers, challenges, and facilitators to implementation, spread and sustainability, perceptions of change in patient flow, clinical care, patient and staff satisfaction, and recommendations and lessons learned. Follow-up interviews will take place in November-December 2009 after improvement strategies have been completed. Data from all interviews is coded into qualitative interview software for analysis.

Results/Outcomes: Results from the qualitative component of the project will be available in the fall of 2009 and will make up the majority of presented findings. While patient-level post-implementation data will not have been analyzed by the time of the conference, the evaluation team will draw from monthly performance data collected by the national program office partners in order to fully illustrate preliminary patient flow improvement results.

Implications: The implications of the study are vast and include possible validation of the participating hospitalÆs improvement strategies and the collaborative model. Hospital Emergency Department leaders will have the opportunity to learn about barriers that similar hospitals face and how they work to overcome them. In addition, hospital leaders will learn more about the use of NQF-endorsed ED throughput performance measures that are likely to be adopted by CMS in the coming years.



Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving Patient Flow and Reducing Emergency Department Crowding Evaluation Designen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162573-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improving Patient Flow and Reducing Emergency Department Crowding Evaluation Design</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">McHugh, Megan, MPP, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Health Research &amp; Education Trust (HRET) of the American Hospital Association (AHA)</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director, Research</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">One North Franklin, Suite 3000, Chicago, IL, 60606, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mmchugh@aha.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Kevin Van Dyke, MPP; Julie Yonek, MPH</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Research Abstract: Improving-Patient-Flow and Reducing-Emergency-Department-Crowding Evaluation Design<br/><br/>Purpose: The purpose of this study is to evaluate the effectiveness of patient flow improvement strategies of six participating hospitals in a nationwide ED learning collaborative aimed at improving patient flow and reducing ED crowding. The goal of the project is to conduct a robust evaluation of the strategies. <br/><br/>Design: The evaluation design includes both a quantitative and qualitative component. For the quantitative component, pre- and post-intervention patient-level data is used to assess the effect of the improvement strategies on patient flow. The qualitative component includes an evaluation of the implementation, costs, and sustainability of the strategies. <br/><br/>Setting: Six diverse hospitals participate in the learning collaborative. They include teaching and non-teaching, for-profit and not-for-profit, and urban and rural hospitals. <br/><br/>Participants/Subjects: All staff participate in the patient flow improvement initiatives implemented by their respective hospitals. Each hospital has a core project team, including a project director, a senior level administrator, and a physician champion. The core team and others directly involved in the implementation of the strategy are interviewed for the qualitative component of the study. <br/><br/>Methods: Patient-level data is used to measure improvement, including ED arrival to departure time for admitted and discharged patients, admit decision time to ED departure for admitted patients, and door-to-provider time. In addition, patient-level demographic data and other data to control for differences in pre- and post-implementation patients are collected. All data is collected pre- and post-strategy implementation, or December 2008-February 2009 and December 2009-February 2010, for all participating hospitals. <br/><br/>In-person site visits will occur during the summer/fall of 2009 to all six hospitals for the purpose of the implementation analysis. Interview questions are asked about rationale for strategy implementation, costs associated with implementation, barriers, challenges, and facilitators to implementation, spread and sustainability, perceptions of change in patient flow, clinical care, patient and staff satisfaction, and recommendations and lessons learned. Follow-up interviews will take place in November-December 2009 after improvement strategies have been completed. Data from all interviews is coded into qualitative interview software for analysis. <br/><br/>Results/Outcomes: Results from the qualitative component of the project will be available in the fall of 2009 and will make up the majority of presented findings. While patient-level post-implementation data will not have been analyzed by the time of the conference, the evaluation team will draw from monthly performance data collected by the national program office partners in order to fully illustrate preliminary patient flow improvement results. <br/><br/>Implications: The implications of the study are vast and include possible validation of the participating hospital&AElig;s improvement strategies and the collaborative model. Hospital Emergency Department leaders will have the opportunity to learn about barriers that similar hospitals face and how they work to overcome them. In addition, hospital leaders will learn more about the use of NQF-endorsed ED throughput performance measures that are likely to be adopted by CMS in the coming years. <br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:30:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:28Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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